Uses
What is rectal nitroglycerin used for?
Rectal nitroglycerin is commonly used to relieve pain in your anal region caused by a tear in the skin of your anus (anal fissure).
Rectal nitroglycerin may also be used for other conditions as determined by your healthcare provider.
How does rectal nitroglycerin work (mechanism of action)?
Rectal nitroglycerin works by relaxing the sphincter muscles in the anus.
How is rectal nitroglycerin supplied (dosage forms)?
Rectal nitroglycerin is available as Rectiv and generic rectal nitroglycerin in the following dosage form that is applied inside the rectum.
- 0.4% rectal ointment
How should I store rectal nitroglycerin?
Rectal nitroglycerin should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep the tube tightly closed. Throw away any unused medicine 8 weeks after opening the tube.
Side Effects
What are the most common side effects of rectal nitroglycerin?
The most common side effects of rectal nitroglycerin are headache and dizziness. Tell your healthcare provider if you have any of these side effects that bother you.
There may be other side effects of rectal nitroglycerin that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at https://www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at https://www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of rectal nitroglycerin?
While less common, the most serious side effects of rectal nitroglycerin are described below, along with what to do if they happen.
Severe Allergic Reactions. Rectal nitroglycerin rectal can cause allergic reactions, which can be serious. Stop using rectal nitroglycerin and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Decreased Blood Pressure (Hypotension). Rectal nitroglycerin may cause low blood pressure. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.
- Dizziness, feeling lightheaded, or fainting
- Confusion
- Feeling weak or tired
Warnings & Precautions
Who should not use rectal nitroglycerin?
Allergies to Ingredients. People who are allergic to any of the following should not use rectal nitroglycerin.
- Nitroglycerin
- Rectiv
- Any other medicine known as nitrates or nitrites
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific rectal nitroglycerin products they stock.
Drug Interactions. Rectal nitroglycerin should not be used while you are using certain other medicines. Before using nitroglycerin, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section below for more details.
Severe Anemia. Rectal nitroglycerin should not be used if you have severe anemia, which is a condition that causes low levels of red blood cells.
Increased Pressure in Your Brain (Intracranial Pressure). Rectal nitroglycerin should not be used if you have increased intracranial pressure such as after a head injury or bleeding in your brain.
What should I know about rectal nitroglycerin before using it?
Do not use rectal nitroglycerin unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
Do not share rectal nitroglycerin with other people, even if they have the same condition as you. It may harm them.
Keep rectal nitroglycerin out of the reach of children.
Cover your finger with a plastic covering or gloves and apply medicine on the finger by following the dosage guide on the carton. Insert the finger into your anus and smear the medicine on the walls of the anus. If it is too painful to insert your finger, apply the medicine on the outside of the anus. Safely throw away the gloves and wash your hands.
Rectal nitroglycerin can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how rectal nitroglycerin affects you.
People who are 65 years of age or older can be at a greater risk for some side effects of rectal nitroglycerin. Talk to your healthcare provider about your risks if you are in this age group.
Slowly rise from a seated or lying position. Hold onto a chair or bed in case you get dizzy.
What should I tell my healthcare provider before using rectal nitroglycerin?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if rectal nitroglycerin is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Low blood pressure
- Heart problems including recent heart attack or heart failure
- Migraines or recurring headaches
Pregnancy. It is not known if or how rectal nitroglycerin could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use rectal nitroglycerin while you are pregnant or trying to get pregnant.
Breastfeeding. It is not known if rectal nitroglycerin passes into breast milk and if it can harm your baby. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use rectal nitroglycerin while breastfeeding.
Interactions
Does rectal nitroglycerin interact with foods or drinks?
There are no known interactions between rectal nitroglycerin and foods or nonalcoholic drinks.
Do not drink alcohol. Your blood pressure may go too low if you drink alcohol while using rectal nitroglycerin.
Does rectal nitroglycerin interact with other medicines (drug interactions)?
- Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
- In particular, make sure that you discuss if you are using any of the following before using rectal nitroglycerin.
- A type of medicine called a phosphodiesterase-5 (PDE-5) inhibitor, such as sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), avanafil (Stendra), or vardenafil (Staxyn), which are used for erectile dysfunction or pulmonary arterial hypertension (PAH)
- A beta-blocker, which is a medicine usually used to reduce blood pressure and for certain other heart conditions
- A medicine for high blood pressure
- Aspirin, which is contained in many prescription and OTC products including those for pain, swelling, and fever
- Ergotamine (Ergomar) or dihydroergotamine (Migranal or Trudhesa), which are medicines used to treat migraine
- A nitrate such as Isordil, Nitro-Dur, NitroMist, or Nitrostat, which is a medicine used to prevent chest pain caused by a type of heart disease
- Riociguat (Adempas), which is used to treat high blood pressure in the lungs
Overdose/Missed Dose
What should I do if I accidentally use too much rectal nitroglycerin?
If you or someone else has used too much rectal nitroglycerin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of rectal nitroglycerin?
If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.
Are you currently using Nitroglycerin rectal?
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